Health Condition, Mobility, Hearing, Speech, or Visual Impairment

A letter or report from treating physician, orthopedic specialist, audiologist, speech pathologist, or ophthalmologist (as appropriate), including:

1. Clearly stated diagnosis
2. Defined levels of functioning and any limitations
3. Current treatment and medication
4. Current letter/report (within 1 year), dated and signed
5. Recommendations to address functional limitations